Pragmatic Language Impairment without Autism

Abstract

The ‘borderlands’ of autism are of particular interest to researchers and clinicians as we learn more about pervasive disorders and how to manage them. One group of children who have caused particular controversy are those referred to as having semantic-pragmatic disorder or pragmatic language impairment. The present article examines the profiles of 10 children (selected from a wider project on language impairment) who are definitely considered to have pragmatic impairments by their teachers, their speech and language therapists and the researchers and on the basis of scores from the Children’s Communication Checklist (CCC). These children are compared with each other and with children with more typical specific language impairments (SLIs) in the wider study. The 10 children’s characteristics are also examined in terms of classification and whether some might be better described using existing autistic spectrum disorder terminology. Children with pragmatic language impairment were all found to have developed first words earlier than the SLI group, but were more impaired than their peers in the areas of stereotyped language, rapport and context. Social communication skills as measured by the CCC did not seem more impaired than in other children with SLI, but on the Harter scale peer interactions were rated as significantly poorer. A preliminary comparison with autistic symptomatology suggested that four of the 10 did have difficulties in this area and might be better described as having autism or Asperger’s disorder.